Medics at the London Summer Olympics are braced for the event of a cardiac arrest
In just three days’ time on the 27 July, the London Summer Olympic Games will finally commence. It is estimated that there will be a total cast of 15,000 taking part in the London 2012 Opening and Closing Ceremonies, which will be watched by an estimated audience of four billion. After being chosen as the host nation for the games back in 2005, it has been a long seven-year wait for British athletes to showcase their talents in diverse sporting events such as football, fencing, basketball, tennis and many more. For the four billion people around the world who will be watching the exciting events unfold on their television screens, it will no doubt be an assumption that these ‘superhuman’ athletes are at the peak of physical fitness, almost immune to ailments. However such assumptions may be slightly naïve. This year alone we have seen seemingly fit and healthy individuals suffer with cardiac arrest, related to underlying heart conditions. When Bolton Wanders footballer Fabrice Muamba collapsed due to cardiac arrest on the White Hart Lane pitch on 17 March, the whole world was shocked by his near-death and the suddenness of the event. Muamba was lucky to receive a rapid response by medical personnel and somehow managed to survive this. Others unfortunately were not as lucky as Muamba. Less than a month after the collapse of Muamba, Italian footballer Piermario Morisini stumbled to the ground in the 31st minute of Livorno’s Serie B match against Pescara. After trying to get up, he collapsed and lost consciousness. Despite receiving medical attention on the field, there was no defibrillator inside the stadium and crucial time was wasted in waiting for one to arrive. In a tragic sense of irony, this happened in a country that is incredibly cautious about cardiac problems and has been routinely screening all athletes since the 1970s. This is done in three main ways; Physical examination and medical history, Lead Electrocardiogram (ECG) and finally by a Transthoracic Echocardiogram (ECHO). After the tragic collapse and death of 32-year old Claire Squires during the London Marathon in May of this year, this has further intensified the spotlight on sudden cardiac arrests. Claire was slim, healthy and was described as a ‘fitness fanatic’ by friends and family. She had even previously successfully run the London Marathon, which made her shock death more difficult to comprehend. After Claire had collapsed on Birdcage Walk close to Buckingham Palace, it was medical director for the marathon, Dr Sanjay Sharma, who desperately tried to save her life. Claire’s death will undoubtedly have had a major emotional impact on Dr Sharma, and as head of the cardiology team for the 2012 Olympics, he will be putting all his efforts into making sure any sudden cardiac arrests or deaths do not rear their head during the games. In fact, Dr Sharma and his team of experts decided to screen approximately 1,000 possible Olympic athletes for any potential underlying cardiac conditions. He says, “We had to screen 32 different squads from various sporting disciplines ranging from athletics to rowing, many of which contained individuals not necessarily going to make the final team. The aim was to identify conditions that could potentially cause sudden cardiac death in an individual.” Of these athletes who were screened, two were discovered to have Wolff–Parkinson–White syndrome (WPW). This is a syndrome that is usually present from birth and involves episodes of rapid heart rate (tachycardia) caused by abnormal electrical pathways (circuits) in the heart. These athletes would not have been authorised to compete at London without having a catheter ablation and Dr Sharma is unaware of whether these particular two individuals ended up successfully making it to the final Olympic squad. In the subsequent recent months since Muamba first collapsed, there has also been the sudden cardiac deaths of the 24-year old expected gold medallist, Norwegian swimmer Alexander Dale-Owen expected gold medallist, and also the death of 24-year old Serbian rower Nemanja Nesic. These distressing occurrences will likely raise fears amongst Olympians says Dr Sharma, who expects a high number of athletes to visit the £17million constructed ‘polyclinic’, the newly built health centre in Stratford, Central London. The medical personnel at the polyclinic are said to include three GPs, three nurses, four sports medicine doctors, six dentists, with 30 physiotherapists on duty at any one time at the clinic. In addition, there will be a further 80 on-call specialists available, including cardiologists, dermatologists, orthopaedic surgeons, ophthalmologists and psychiatrists. Dr Sharma spoke about how the high-profile cardiac incidents of this year, will probably raise concern, saying, “We may have athletes who complain of symptoms suggestive of cardiac disease. Chest pain is common, and it's not always due to cardiac causes. It may be due to a musculoskeletal injury or maybe pleurisy because they have caught a cold. I anticipate athletes coming in with palpitations, which can happen with anxiety, or if you've hit the caffeine or been training very hard. Or there may be an athlete who is not used to too much pollen who gets more breathless every time they exercise.” Athletes at the games need not worry too much though and should try to relax and enjoy themselves. They are in safe hands as Dr Sharma says the cardiac emergency response has been thoroughly planned. There will be a huge availability of defibrillators and a high number of medical staff who can carry out cardiopulmonary resuscitation and defibrillation. “There will be at least one automated external defibrillator for every mile of the marathon, but there will be cycle responders in between who will be carrying AEDs”, says Dr Sharma. He further attempted to alleviate any worries and said, “I’m not expecting any catastrophes.” Medical Specialists Pharmacy wishes a safe and enjoyable experience for all the athletes who are involved at the 2012 London Summer Olympic Games and we will be proudly supporting Team GB in their quest for gold. Let the games begin!